Overview

Stage 4 prostate cancer is cancer that begins in the prostate and grows to involve nearby organs or spreads to other areas of the body.

Stage 4 prostate cancer is an uncommon diagnosis. Most cases of prostate cancer are diagnosed at an earlier stage, when the cancer is confined to the prostate.

Treatments may slow or shrink an advanced prostate cancer, but for most men, stage 4 prostate cancer isn't curable. Still, treatments can extend your life and reduce the signs and symptoms of cancer.

Symptoms

Signs and symptoms of stage 4 prostate cancer may include:

  • Painful urination
  • Decreased force in the stream of urine
  • Blood in the semen
  • Erectile dysfunction
  • Bone pain
  • Swelling in the legs
  • Fatigue
  • Frequent infections

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.

Causes

Doctors aren't certain what causes stage 4 prostate cancer.

Stage 4 prostate cancer occurs when a prostate cancer grows large enough to involve nearby organs, such as the bladder, or when cancer cells break away from the prostate and spread to other areas of the body.

Prostate cancer cells that spread beyond the prostate most often travel to the:

  • Lymph nodes
  • Bones
  • Liver

Risk factors

Factors that may increase your risk of stage 4 prostate cancer include:

  • A family history of prostate cancer. Men with certain inherited gene mutations have an increased risk of more aggressive prostate cancers.
  • African-American race. Black men have an increased risk of aggressive prostate cancer.

Stage 4 prostate cancer care at Mayo Clinic

May 10, 2014
References
  1. Niederhuber JE, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed March 17, 2014.
  2. Prostate cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed March 17, 2014.
  3. Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://wwwclinicalkey.com. Accessed March 17, 2014.
  4. Dawson NA. Overview of the treatment of disseminated prostate cancer. http://www.uptodate.com/home. Accessed March 17, 2014.
  5. Adult cancer pain. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed March 17, 2014.
  6. Coping with advanced cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/coping/advancedcancer. Accessed March 17, 2014.
  7. Zytiga (prescribing information). Horsham, Pa.: Janssen Biotech Inc.; 2013. http://www.zytiga.com. Accessed March 17, 2014.
  8. Xtandi (prescribing information). Northbrook, Ill.: Astellas Pharma US Inc.; 2013. http://www.xtandi.com. Accessed March 17, 2014.
  9. Xofigo (prescribing information). Wayne, N.J.: Bayer HealthCare Pharmaceuticals Inc.; 2013. http://www.xofigo.com. Accessed March 17, 2014.
  10. Castle EP (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. April 6, 2014.
  11. Sartor AO. Risk factors for prostate cancer. http://www.uptodate.com/home. Accessed April 16, 2014.
  12. Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. April 17, 2014.